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Exercise is medicine.Exercise is not only the cornerstone of children′s normal growth and development, but also the necessary condition of physical and mental health.Moreover, exercise contributes to the management of childhood asthma.Exercise prescription is an effective method for children with asthma, but there is no much experience in China, we should continuously explore and optimize it.Therefore, the level of physical activity could be improved in children with asthma.
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Objective:To investigate the etiological diagnostic value of metagenomic sequencing in central nervous system (CNS) infectious diseases.Methods:A total of 170 patients with central nervous system infection admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2020 were selected as the study subjects according to inclusion and exclusion criteria. General clinical data and pathogen test results were collected. All included patients underwent routine examination and mNGS test, and were divided into the conventional method test group and mNGS test group according to the test results. The measurement data conforming to normal distribution were represented by ± s; The measurement data that did not conform to normal distribution were represented by median and interquartile range. The classification data were expressed by the number of cases and percentage( n,%), and were compared by χ2 test or Fisher's exact test. Consistency test was represented by Kappa value. The detection of pathogenic microorganisms by the two methods and the rule of pathogen spectrum were compared and analyzed. Results:The overall positive rate of mNGS in CNS infectious diseases was higher than that of conventional methods (58.23% vs. 18.82%), and the difference was statistically significant ( P<0.01). Among the 20 samples which were both positive by the two methods, 10 cases were completely pathogenic, 5 cases were partially consistent and 5 cases were completely inconsistent. In the detection of tuberculous nervous system infection, the positive rates were 66.7%, 53.8%, 44.0%, 40.0%, 4.0% in blood T-SPOT, cerebrospinal fluid mNGS, ADA, Mycobacterium tuberculosis DNA and tuberculous specific antibody, respectively. The positive rate of acid-fast staining was 0. The positive rate of mNGS combined with conventional method was 80.8%. Conclusions:The detection rate of mNGS in CNS infection is better than that of conventional methods. However, it does not show obvious superiority in the detection rate of Mycobacterium tuberculosis associated nervous system infection. In general, mNGS detection of pathogenic bacteria is more extensive, which is conducive to a thorough and comprehensive understanding of the bacterial characteristics of central nervous system infection. The combination of the two methods can make up for the deficiency of clinical routine detection to a certain extent, and can maximize the detection rate.
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Objective:To analyze the clinical characteristics of patients with acute glyphosate herbicide poisoning and the differences in the severity of poisoning.Methods:A retrospective analysis was performed on patients with acute glyphosate herbicide poisoning admitted to the First Affiliated Hospital of Zhengzhou University from January 2014 to December 2020. The general information, exposure time, poisoning dose, poisoning cause, poisoning route, clinical manifestations, laboratory examination results during hospitalization, treatment measures, hospital stays and prognosis of the patients were collected. The patients were graded according to the poisoning severity scoring standard of Chinese Expert Consensus on Diagnosis and Treatment of Acute Poisoning in 2016. The highest severity score during hospitalization was used as the final grade. According to the final grade, asymptomatic and mild patients were included in the mild group, and moderate, severe and death patients were included in the severe group. The independent sample T test or Mann-Whitney U test was used for measurement data, and χ2 test or Fisher's exact test was used for counting data. The differences of general data and clinical data between the two groups were compared. Results:According to the inclusion and exclusion criteria, 83 patients with acute glyphosate herbicide poisoning were selected as the study subjects. All patients survived, mainly mild poisoning (56.6%), with a male to female ratio of 33∶50, and an average age of 39 years. The number of poisoning cases increased yearly (the highest in 2019), and most cases occurred in spring and summer. The main cause of poisoning was suicide (71.1%), direct oral administration (83.1%) was the primary route of poisoning, and the dominating clinical manifestations were digestive symptoms (71.1%). Laboratory tests showed increased white blood cell count (WBC), neutrophil percentage (NEUT %) and D-dimer, and decreased hemoglobin and potassium. Compared with the mild group, patients in the severe group were older [(51±17) years vs. (35±19) years], had a higher proportion of suicide and direct oral administration, a longer hospital stay [8.0 (4.8, 12.0) d vs. 3.0 (2.0, 5.5) d], a higher dose of poisoning [200.0 (50.0, 200.0) mL vs. 30.0 (11.3, 57.5) mL], and higher NEUT % within 24 h of admission [(83.4±10.4) vs. (73.2±12.8)]. The increase of WBC, NEUT %, aspartate aminotransferase, prothrombin time, D-dimer and the decrease of serum potassium were more common in the severe group than the mild group, with statistical significance (all P<0.05). Conclusions:The number of patients with acute glyphosate herbicide poisoning is increasing yearly. Generally, the condition is mild and the prognosis is satisfying. The severity is more serious in the middle-aged and elderly patients andthose with direct oral administration, high toxic dose, and high NEUT % within 24 h of admission. Severe poisoning is more likely to cause changes in laboratory indicators.
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Objective:To explore and analyze the relationship between serum KLK11 and MK levels and the effect of first iodine 131 ( 131I) ablation after operation for differentiated thyroid cancer. Method:108 patients with differentiated thyroid cancer who underwent total thyroidectomy in our hospital from Jun. 2020 to Jun. 2021 were consecutively selected, and received radioactive ablation after surgery. There were 37 males and 71 females. The age was (48.32±4.25) years, ranging from 28 to 79 years. The patients were divided into successful ablation according to whether the ablation was successful after treatment. There were 64 cases in the group and 44 cases in the unsuccessful group, and 60 healthy people with no abnormality in physical examination during the same period were selected as the control group. The patients were divided into a metastasis-positive group of 20 cases and a metastasis-negative group of 88 cases according to whether lymph nodes occurred. After surgery, serum samples of all subjects were taken, and enzyme-linked immunosorbent assay was used to detect the levels of serum kallikrein-related peptidases 11 (KLK11) and midkine (MK) , and the levels of serum KLK11 and MK were analyzed. Gender, age, BMI, TNM stage, TSH, maximum diameter of lesion, and duration of nail removal were collected. Univariate analysis and logistic regression analysis were used to analyze the independent risk factors of postoperative efficacy.Result:The levels of serum KLK11 and MK in the successful and unsuccessful groups were higher than those in the control group, while the levels of KLK11 and MK in the unsuccessful group were higher than those in the successful group (KLK11: t= 2.642, P<0.05; MK: t=11.906, P<0.05) . The serum levels of KLK11 and MK in the metastasis-positive group were higher than those in the metastasis-negative group (KLK11: t= 2.908, P<0.05; MK: t=14.907, P<0.05) . Univariate analysis showed that BMI ( χ2=6.780, P=0.009) , maximum diameter of lesions ( χ2=14.819, P=0.001) , TSH ( χ2=13.627, P=0.001) , serum KLK11 ( t=2.642, P=0.01) , and serum MK ( t=11.906, P<0.001) were associated with the effect of first 131I ablation after surgery for differentiated thyroid cancer ( P<0.05) . Taking the success of ablation as the dependent variable, a multivariate logistic regression analysis was performed. The results showed that the maximum diameter of the lesions greater than 2 cm ( OR=10.740, 95%CI: 7.033-16.401) , increased level of TSH ( OR=8.559, 95%CI: 2.812-26.057) , increased serum KLK11 level ( OR=16.710, 95%CI: .548-32.666) and increased serum MK level ( OR=10.580, 95%CI: 6.294-17.786) were the factors affecting the first 131I ablation effect after DTC surgery ( P<0.05) . Conclusion:The elevated levels of serum KLK11 and MK are independent risk factors affecting the efficacy of the first 131I ablation after surgery for differentiated thyroid cancer.
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Objective:To explore the related risk factors of secondary thoracotomy to stop bleeding after rheumatic heart disease valve replacement.Methods:A retrospective analysis of 373 patients in the Department of Cardiac Surgery of the First Hospital of Shanxi Medical University who underwent rheumatic heart disease valve replacement surgery from December 2013 to October 2020. According to whether or not to perform secondary thoracotomy to stop bleeding after operation, they were divided into two thoracotomy case group and control group. Collect the relevant clinical data of the patients, and analyze the risk factors that affect the second postoperative thoracotomy to stop bleeding through univariate and multivariate Logistic regression.Results:Among the 373 patients, 62 cases (16.62%) were in the secondary thoracotomy group and 311 cases (83.38%) were in the control group. Univariate analysis showed that the patient' s age, gender, prehospital cardiac function classification, pulmonary artery pressure, hemoglobin value (Hb), prothrombin time (PT), operation time, combined hypertension, intraoperative blood transfusion and postoperative two The occurrence of secondary thoracotomy to stop bleeding was related, and the difference was statistically significant ( P<0.05). The results of unconditional logistic regression analysis showed that prehospital cardiac function classification, Hb, PT, and hypertension are the risk factors leading to secondary thoracotomy to stop bleeding after rheumatic heart disease valve replacement. Conclusion:Effective control of risk factors can reduce the incidence of secondary thoracotomy after rheumatic heart disease valve replacement, and reduce the risk caused by secondary operations.
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The construction of medical knowledge platform is a core value of the intelligent construction of electronic medical records. The hospital-wide knowledge base construction covers a wide range of content, including multiple healthcare scenarios such as medicine, testing, inspection, surgery, blood transfusion and nursing. This article introduced how Jiangsu Province People′s Hospital used knowledge graphs and rule engine to construct a hospital knowledge management platform, realize the integration of knowledge-based knowledge base and a non-knowledge-based knowledge base, and embed clinical diagnosis and treatment rules into the information system for different flexible application scenarios.Finally, a multi-dimensional knowledge base was formed to realize the unified knowledge information integration of various clinical expert knowledge, and to provide integrated display and decision support for all departments, as well as realizing real-time data verification, prompting and control in each link.
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Objectives To investigate the clinical significance of CYP2C19 genotype detection for antiplatelet therapy of elder cardiovascular and cerebrovascular diseases(CCVD).Methods We enrolled all elderly patients with either cardiovascular or cerebrovascular disorders who received clopidogrel as mono drug or in combination with another antiplatelet drug aspirin as secondary prevention for more than 12 months in our hospital from January to August 2015.Somatotypes of CYP2C19 genotypes of all participants were assessed to analyze the relapse of cardiac-cerebral vascular diseases in these patients.Results A total of 250 patients were enrolled,including 179 male and 71 female,with average age of (85.2 ± 7.9) years.Among these patients,there were 97 (38.8％) cases with EM CYP2C19 genotypes,110 cases(44.0 ％) with IM CYP2C19 genotypes,43 cases(17.2 ％) with PM CYP2C19 genotypes.When treated with clopidogrel for antiplatelet in secondary prevention process,the rate of the relapse in cardiovascular event was 34.9％ and higher in PM CYP2C19 genotype than in EM and IM CYP2C19 genotype (19.6 ％ and 15.5 ％,respectively) (x2 =7.251,P =0.027).This phenomenon was similar to patients who received stent implantation(x2=6.393,P =0.041).However,no statistically significant difference was observed in the recurrence rate of cerebral vascular disease between three different genotypes(EM 29.9 ％,IM 20.0 ％,PM 27.9％,x2 =2.880,P =0.237).Conclusions Our results highlight that CYP2C19 genotype might be a potential guidance for secondary prevention of cardiovascular and cercbrovascular disorders among elderly patients.Clopidogrel may be less effective in patients with SM CYP2C19 genotype than those with EM or PM CYP2C19 genotype for secondary prevention of cardiovascular disease.
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Objective To understand the current situation of scientific exercise literacy of middle school students,including basic knowledge,attitude,skills and exercise habits.Methods One middle school was selected from each of Shulan county in Jilin province,Wuxi city in Jiangsu province and Chengdu city in Sichuan province,including two junior high schools and one senior high school.Two classes were randomly selected in each grade from each of the three schools.All students in the selected classes took part in the study.1 360 questionnaires were distributed and all were collected,1 355 of them were qualified questionnaires.The questionnaire contains knowledge (12 items),attitudes (10 items),skills (1 items) and habits (3 items).The one who correctly answered 80％ or more of the questions was considered as having the competent literacy.Results Among middle school students,27.4％ had the scientific exercise literacy,47.5％ had the knowledge literacy and 49.0％ had the attitudes literacy for scientific exercise.68.8％ reported regular exercise,but only 12.5％ had exercise habits.Conclusion The level of scientific exercise literacy among middle school students is low,suggesting that multiple measures should be taken to improve scientific exercising knowledge and concept among middle school students,helping them to develop a scientific exercising habit and improve their literacy of scientific exercising.
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Monoclonal antibody ( mAb ) represents a class of therapeutics experienced dramatic development over the past 30 years. Because of the tremendous differences in physicochemical and biological properties between mAbs and small molecules, the mAb therapeutics significantly differ from the chemical drugs in pharmacokinetic characteristics and underlying mechanisms. Full understanding of those characteristics and mechanisms may efficiently guide the screening and development of mAb medi-cines, and would well support their safety evaluation and clinical dosage regimen designing. This review is to summarize pharma-cokinetics and underlying mechanisms of mAbs from the aspects of absorption, distribution and elimination, as well as the ap-proaches for prediction of mAb pharmacokinetics in humans.
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Dysfunction in tyrosine kinase activity disrupts the nor-mal control of cellular phosphorylation signaling pathways,which plays a vital role in genesis and development of various tumors, and makes tyrosine kinases a class of targets of many anti-tumor drugs. Currently most approved tyrosine kinase inhibitors ( TKIs) are based on irreversible binding mechanisms, making them poorly selective, not potent or sustained enough regarding pharmacological effects and prone to triggering resistance. In the past decade, much progress has been made in the development of a new class of TKIs which irreversibly inhibit their target proteins via the formation of covalent bonds, overcoming the drawbacks of irreversible TKIs. Several irreversible TKIs have entered markets or clinical research phases. This review is to summarize the structural, pharmacological and medicinal chemical properties of investigational and marketed irreversible TKIs as well as their re-cent developments.
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Antibody-drug conjugate (ADC) is a new class of therapeutics composed of a monoclonal antibody and small cytotoxin moieties conjugated through a chemical linker. ADC molecules bind to the target antigens expressed on the tumor cell surfaces guided by the monoclonal antibody component. The binding ADC molecules can be internalized and subsequently the toxin moieties can be released within the tumor cells via chemical and/or enzymatic reactions to kill the target cells. The conjugation combines the merits of both components, i.e., the high target specificity of the monoclonal antibody and the highly potent cell killing activity of the cytotoxin moieties. However, such complexities make the pharmacokinetic and metabolic studies of ADCs highly challenging. The major challenges should include characterization of absorption, distribution, metabolism and excretion, investigation of underlying mechanisms, assessment of pharmacokinetic- pharmacodynamic relationship, and analytical method development of ADC drugs. This review will discuss common pharmacokinetic issues and considerations, as well as tools and strategies that can be utilized to characterize the pharmacokinetic and metabolic properties of ADCs.
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Objective To evaluate the clinical efficacy of green light photoselective vaporization(PVP)combined testicular resection plus anti-androgen treatment on advanced prostate cancer and bladder outlet obstruction.Methods Twenty cases with PVP of advanced prostate cancer and bladder outlet obstruction were selected as our subjects,who underwent PVP testicular resection plus anti-androgen treatment.The clinical information was recorded.Results All patients were succeed through surgery.Maximum urinary flow rate (MFR) at the pre-operation was (2.0 ± 1.0) ml/s,and increased to (14.0 ± 4.5) ml/s after operation.Serum prostate specific antigen (PSA) was decreased from the preoperative (176.5 ± 160.5) μg/L to (2.0 ± 1.0)μg/L International prostate symptom score (IPSS) was from (25.0 ± 5.0) down to (8.0 ± 1.0) points.The quality of life (QOL) score was (4.0 ± 2.0) at pre-operation,higher than after operation (1.0 ± 1.0)points.There were significant differences between preoperative and postoperative (t =9.502,7.371,5.328,8.350,P ＜0.05).Every patient was followed up from 3 to 18 months.The improvements regarding of clinical symptoms were seen including voiding,and all patients survived with tumor.Conclusion Advanced prostate cancer associate with bladder outlet obstruction.The therapy plan of PVP joint testicular resection plus antiandrogen is proved to improve symptoms of urethral obstruction and patient quality of life.
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Objective To evaluate the safety of simultaneous transurethral green laser vaporization therapy in benign prostatic hyperplasia (BPH) and nonmuscle-invasive bladder transitional cell carcinoma (NMIBT).Methods The clinical data of 27 patients (observation group) who had undergone simultaneous transurethral green laser vaporization therapy in BPH and NMIBT between May 2004 and October 2010 were analyzed retrospectively.Meanwhile 27 patients(control group) only had undergone green laser vaporization therapy in NMIBT during the same period were selected.Clinicopathologic parameters,rate of recurrence and progression,rate of recurrence in the bladder neck and prostatic urethra were determined and compared.Results The time of follow-up in observation group and control group were (28.61 ± 19.53) and (30.20 ± 21.46) months.The rates of recurrence,progression and recurrence in the bladder neck and prostatic urethra between observation group and control group had no significant differences [ 18.5％ (5/27) vs.25.9％ (7/27),3.7％ (1/27) vs.0,0 vs.0] (P ＞0.05).Conclusion Simultaneous transurethral green laser vaporization of NMIBT and BPH can be safely performed without increasing the risk of tumor recurrence in the prostatic urethra.
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Objective To explore the efficacy and safety of greenlight photoselective vaporization of prostate (PVP) in high-risk elder patients with benign prostatic hyperplasia (BPH). Methods A total of 120 high-risk elder patients with BPH underwent PVP procedure. The operating time, blood 1oss, indwelling catheterization and operation-related complications were monitored. The variables such as international prostate symptom score (IPSS), Quality of life (QOL) score, maximum urinary flow rate (Qmax) and residual urine volume (RUV) were recorded and compared pre- and post-operatively. Results All the 120 patients had a good peri-operative condition. The mean operating time was (52. 6 ± 5.8 )min, intraoperative blood loss was (20.4 ±9.5) ml. Among the 120 cases,26 did not received postoperative catheterization. In the other 94 cases received postoperative catheterization, the mean catheterization time was (24. 5 ± 15.9) hour. IPSS and QOL scores decreased from (28.5 ± 3.8) and (5.0 ± 0.8) preoperatively to (7.2 ± 1.8) and (1.5 ± 0.6)postoperatively. Qmax increased from ( 5.2 ± 3.1 ) ml/s to ( 15.2 ± 4.3 ) ml/s, and RUV decreased from ( 118.6 ± 15.2) ml to ( 16. 5 ± 4. 6) ml. There was significant difference for these parameters before and after the operation (Ps ＜ 0. 05 ). Conclusion The PVP is considered to be a safe, effective and minimally invasive procedure to treat BPHin high-risk elder patients. It is easy to manipulate, with advantages of shorter operating time,less blood loss, better tolerance and rapid recovery, especially for high-risk elder patients with BPH.
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Objective To investigate radiation dose to the patients undergoing interventional radiology and make radiation risk assessment.Methods Data was collected on 198 instances of 10 interventional radiology procedures by using Philips Allura Xper FD20 DSA, which was equipped with the transparent ionization chamber system in compliance with IEC 60601-2.Patient peak skin dose and effective dose were estimated.Results Cumulative fluoroscopy time was 2.1 - 80.9 min, and number of images monitored for PSD were above 1 Gy and 79 cases monitored for E were above 20 mSv.Conclusions Substantial number of cases exceeded the dose threshold for erythema.Due attention should be paid to radiation protection of patients.
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Objective To discuss the application of C-arm CT scanning technology in performing transcatheter arterial chemoembolization for hepatic cancer.Methods Seventy-seven patients of hepatic cancer were treated with selective transcatheter arterial chemoembolization(TACE),which was followed by C-arm CT scanning to observe the embolization effect.C-arm CT scanning was also performed before TACE in 13 cases.Three-dimension reconstruction of the images was carried out on Integris 3D-RA workstation.The therapeutic results were evaluated.Results The embolization state of both the peripheral margin and the body of the tumor could be clearly displayed on CT scans in all 77 patients.Some tiny liver lesions were also detected in 3cases.Conclusion C-arm CT scanning technology is a newly-developed high-tech examination.This examination is very helpful for making the proper operation scheme and for evaluating the curative effect of intravascular intervention.Compared to the traditional CT scanning,C-arm CT scanning can provide more accurate information and stereoscopic image of the lesions,therefore,the whole course of the interventional procedure can be entirely under the operator's control and the curative effect can be evaluated at any time during the operation.C-arm CT scanning can be effectively employed in interventional therapy for multisystemic disorders.
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Objective To study the main infectious bacteria and their drug-resistance after liver tra nsplantation. Methods K-B method was used to detect the susceptibility of agents of the main bacteria after liver transplantation. ESBLs and AmpC ?-lactamase among the main negati ve bacillus were detected by three-dimensional tests. ?-lactamase and Van gen e among Enterococcus were dectected by standard agar dilution susceptibility tes ts and Nitrocefin respectively. Results Among the main Gram-negative bacteria in 55 cases of infection following liver transplantation, the ratio of resistance to 4 or more antibiotic were all beyond 40% . The detectable rate of ESBLs and AmpC ?-lactamases in Enterobacter cloacae and Escherichia coli was 32.4% and 36.8% , and 33.8% and 10.5% re spectively. Moreover, the detectable rate of both ESBLs and AmpC ?-lactamases in Enterobacter cloacae and Escherich ia coli was 24.3% and 7.0% repectively. 8.8% and 11.1% produced ?-lactamases in Enterococcus faec alis and Enterococcusfaecium, with the ratio of resistance to Vancomycin being 11.2% and 18.5% respectively. Conclusions The primary pathogens have the high and multiple resistance to antimicrobial aft er liver transplantation. ESBLs and AmpC ?-lactamases were the main two factor s of drug-resistance among Gram-negative bacillus. we should pay much attentio n to the high detectble rate of Enterococcus which are resistant to Vancomycin a fter liver transplantation.
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Objective To investigate the changes of plasma epinephrine (E) and norepinephrine (NE) in rabbits with firearm thoracic wounds. Methods A total of 24 rabbits were divided into 3 groups randomly, the simple thoracic penetrating injury group (Group A, n = 8), the pseudo-injury group (Group B, n = 8)and the normal control group ( Group C, n = 8). The pressures of carotid artery and jugular vein were recorded by eight-road physiological recorder at 5 minutes before injury. And the concentrations of plasma E and NE were detected through high-performance liquid chromatography (HPLC) and electrochemical detection (ED) at 5 minutes, 30 minutes, 1 hour, 3 hours, 6 hours, 12 hours and 24 hours after injury in all the rabbits. Results The concentrations of plasma E and NE in Group A were significantly higher than those of Group C (P<0.01) and changed regularly. There was no significant difference between Group B and Group C. The pressures of carotid artery and jugular vein of Group A increased by 1.8 and 6.8 times, respectively, during 2 millisecond after injury, then decreased to normal immediately. They decreased to the minimum (0.63 and 0.25 time, respectively) in 30 minutes and 5 minutes respectively and averagely, and raised to normal slowly after 6 hours and 12 hours respectively and averagely. There was no significant difference between Group B and Group C. Conclusions The concentrations of plasma E and NE increase significantly in the rabbits with thoracic firearm wounds. Their changes have close relationship with the severity of wound and can be used as a judging criterion during the early period of wound.
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AIM: To investigate the mechanism of proliferation and differentiation of human epidermal stem cells cultured in vitro under the influence of compressive stress.METHODS: Epidermal stem cells were isolated by adhering to type IV collagen and were cultured with conditioned medium,then were detected by Powervision~(TM) two-step immunohistochemical method with keratin 19 and cell cycle analysis.The cultured epidermal stem cells transplanted on silica gel membranes,which were put in a new apparatus,was designed to offer cell culture and intermittent compressive stress(4 kPa,6 kPa,8 kPa,10 kPa,12 kPa) for 2 h,3 times a day simultaneously.A week later,cells on silica gel membranes were identified with keratin 19 and 10 by Powervision~(TM) two-step immunohistochemical method.RESULTS: The new apparatus offered cell culture and intermittent compressive stress simultaneously.The isolated and cultured epidermal stem cells were identified with keratin 19 positive and 84.80 percent of them were showed in G_1 period with cell cycle analysis.Cells on silica gel membranes had been subjected intermittent compressive stress above 8 kPa for a week.The number of the cells was increased,which was more than that in control group.However,some cells identified by immunohistochemical staining with keratin 10 positive were detected among the disposed epidermal stem cells.CONCLUSION: The intermittent compressive stress above 8 kPa induces and promotes epidermal stem cells to proliferate and differentiate,indicating that epidermal stem cells respond to mechanical stress,probably is one of their major biological features.